St. Mark's Hospital in Salt Lake City (Mountainstar Healthcare)
SALT LAKE CITY — All week long, we’re going in-depth on the sticker shock many Utahns experience after seeing how much hospital treatment can cost for COVID-19. Tune to Jeff Caplan’s Afternoon News daily at 3:45 p.m. for updates.
As it turns out, calculating an average cost for a COVID-19-related hospital stay proves tricky because of a number of variables that can affect the price.
Early in the pandemic, many insurers waived “cost-sharing” for COVID-19, meaning that if your plan included co-pays for hospital stays or important tests or procedures, those did not apply to a stay related to coronavirus. However, a Peterson/Kaiser Family Foundation study of the cost of COVID-19 among the unvaccinated found many insurers are starting to reinstate those shared costs.
Niall Brennan, president and CEO of the Health Care Cost Institute, a non-profit group that collects data on insurance claims to help track costs across the medical industry, told the Detroit Free Press those variables include whether a patient requires ventilator or ICU treatment.
He said for every patient who needed intubation, there would be another patient who was in and out of the hospital in a couple of days. Obviously, their out-of-pocket costs would look much different.
The Peterson/KFF study estimated an average $20,000 bill for a COVID-19 hospital stay. But another organization that analyzes health care claims, FAIR Health, estimates the average hospital stay for an uninsured patient, or someone seeking care out-of-network, at around $73,000. FAIR Health came about that figure by analyzing hospital stays for flu and pneumonia, which can result in similar treatment plans.
The estimated total cost for a COVID-19 patient with insurance was just over half as much, at $38,000, according to FAIR Health. That’s not necessarily how much the patient pays out-of-pocket: it combines the amount paid by the insurance plan and the amount charged to the patient.
The insured patient’s out-of-pocket cost for COVID-19 depends on their individual insurance plan. For example, a plan with a 10% co-pay for inpatient hospital stays in-network would still result in a $3,800 bill assuming the average of $38,000 above is correct.
But many plans include shared costs on other hospital tests and procedures. For example, if your plan charges a 30% co-pay on tests like an MRI or a CT scan, that would add to the average as well.
The Utah state auditor’s website includes a tool to calculate various estimated medical costs, such as hospital stays. While it does not currently include data for COVID hospitalization, you can look up the cost for various treatment options at different hospitals using that site. That information is available at https://healthcost.utah.gov/.
COVID-19 coronavirus spreads person to person, similar to the common cold and the flu. So, to prevent it from spreading:
Utah’s Coronavirus Information
The Church of Jesus Christ of Latter-day Saints
Utah Coronavirus Information Line – 1-800-456-7707
Centers for Disease Control and Prevention